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Medicare Now Covers PET/CT Scans for Prosthetic Infection/Inflammation and Osteomyelitis

Northern California PET Imaging Center (NCPIC) would like to announce Medicare’s expanded coverage guidelines adding (fluorodeoxyglucose) F-18 FDG PET/CT imaging for:

  • chronic osteomyelitis and chronic hematogenous osteomyelitis of the entire skeletal system
  • infection and inflammatory reaction to internal joint prosthesis (any joint prosthesis)
  • unspecified fever which may be associated with inflammation and/or infection

Coverage is effective immediately for individuals enrolled in traditional Medicare and Medicare Advantage plans. Individuals enrolled in a Medicare Advantage plan will require pre-authorization.  Private payer coverage will be on a case-by-case basis with prior authorization required. Attached is a requisition form for NCPIC and a listing of approved ICD-10 codes.  Should you need personalized assistance with your request or authorization help, please call us at (916) 737-3211.